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Risk Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer

  • Hiroshi YajimaEmail author
  • Naoto Takahashi
  • Noburo Omura
  • Keishiro Murakami
  • Norio Mitsumori
  • Katsuhiko Yanaga
Original Article
  • 32 Downloads

Abstract

The indication for endoscopic resection is differentiated gastric cancer ≤ 2 cm in size without an ulcer, of which the depth of invasion is clinically diagnosed as tumor confined to the mucosa. Endoscopic resection is not indicated for undifferentiated gastric intramucosal carcinoma, which is associated with a high rate of lymph node metastasis. This study aimed to analyze the factors associated with lymph node metastasis and to determine the validity of endoscopic resection in patients with undifferentiated early gastric cancer (EGC). This study included 141 patients who underwent gastrectomy with lymph node dissection for undifferentiated EGC. The clinicopathological findings were retrospectively analyzed to identify the factors associated with lymph node metastasis. According to the depth of tumor invasion, lymph node metastasis was observed in 13 patients (9.2%), including three with intramucosal carcinoma (3.6%) and ten with submucosal invasive carcinoma (17.2%). Univariate analysis identified tumor size (p = 0.038), depth of tumor invasion (p = 0.008), and lymphovascular invasion (LVI) (p = 0.0002) as risk factors for lymph node metastasis. On multivariate analysis, LVI (p = 0.002) was identified as the only independent risk factor for lymph node metastasis. The use of endoscopic resection for the undifferentiated EGC should be considered carefully for patients with LVI because of the risk for lymph node metastasis.

Keywords

Endoscopic resection Lymph node metastasis Risk factor Undifferentiated early gastric cancer 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Association of Surgeons of India 2018

Authors and Affiliations

  1. 1.Department of Surgery, Kashiwa HospitalThe Jikei University School of MedicineKashiwa-cityJapan
  2. 2.Department of SurgeryThe Jikei University School of MedicineTokyoJapan

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